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远程心血管康复可改善老年人的功能能力、心肺适能和生活质量:系统评价和荟萃分析。

Cardiovascular telerehabilitation improves functional capacity, cardiorespiratory fitness and quality of life in older adults: A systematic review and meta-analysis.

机构信息

Laboratory of Exercise Physiology, School of Physical Education, State University of Campinas, Campinas, SP, Brazil.

Gerontology Program - School of Medical Sciences, State University of Campinas, Campinas, SP, Brazil.

出版信息

J Telemed Telecare. 2024 Sep;30(8):1238-1248. doi: 10.1177/1357633X221137626. Epub 2022 Dec 5.

DOI:10.1177/1357633X221137626
PMID:36469017
Abstract

INTRODUCTION

The aim was to identify whether cardiovascular telerehabilitation programs (CV-T-REHAB) can improve functional capacity, cardiorespiratory fitness and quality of life (QoL) to the same extent of presential rehabilitation (CV-P-REHAB) in older adults, by meta-analysis of previous studies.

METHODS

Literature search was conducted in October 2020 in four databases to select controlled trials of CV-T-REHAB effects on functional capacity (six-minute walk test [6MWT]), cardiorespiratory fitness (maximal oxygen consumption [O]), and QoL in older adults (> 50 years) and included new articles in April 2022.

RESULTS

CV-T-REHAB improved 6MWT (11.14 m [CI95% = 8.03; 14.26],  < 0.001), O (1.18 ml/kg/min [CI95% = 0.70; 1.66],  < 0.001), and QoL (standardized mean difference [SMD] = 0.36 [CI95% = 0.05; 0.67],  = 0.02). CV-T-REHAB increased O to a greater extent than CV-P-REHAB (1.08 ml/kg/min [0.39; 1.76],  = 0.002). Although the 6MWT and O analyses proved consistent and homogeneous, the QoL analysis showed considerable inconsistency ( = 92.90%), suggesting the need for studies exploring the effect of CV-T-REHAB on QoL in this population. Part of the heterogeneity was explained by age differences, as CV-T-REHAB improved QoL in adults >65 years, but not in adults <64 years.

CONCLUSION

CV-T-REHAB improved cardiorespiratory fitness to a level equal to or higher than CV-P-REHAB and improved functional capacity and QoL; being mainly effective for QoL in older adults >65 years. Thus, CV-T-REHAB can be a good alternative, when not the best option and might be considered especially for individuals with limited access to participate in face-to-face programs.

摘要

简介

本研究旨在通过对先前研究的荟萃分析,确定心血管远程康复(CV-T-REHAB)是否能在改善功能能力、心肺适能和生活质量(QoL)方面与传统康复(CV-P-REHAB)达到相同的效果。

方法

于 2020 年 10 月在四个数据库中进行文献检索,以选择 CV-T-REHAB 对老年人(>50 岁)功能能力(6 分钟步行试验[6MWT])、心肺适能(最大摄氧量[O])和 QoL 的影响的对照试验,并纳入 2022 年 4 月的新文章。

结果

CV-T-REHAB 改善了 6MWT(11.14m [95%CI95%=8.03; 14.26],  < 0.001)、O(1.18ml/kg/min [95%CI95%=0.70; 1.66],  < 0.001)和 QoL(标准化均数差 [SMD]=0.36 [95%CI95%=0.05; 0.67],  = 0.02)。CV-T-REHAB 使 O 增加的程度大于 CV-P-REHAB(1.08ml/kg/min [0.39; 1.76],  = 0.002)。虽然 6MWT 和 O 的分析结果具有一致性和同质性,但 QoL 分析显示出明显的不一致性( = 92.90%),这表明需要研究探索 CV-T-REHAB 对该人群 QoL 的影响。部分异质性可以通过年龄差异来解释,因为 CV-T-REHAB 改善了>65 岁成年人的 QoL,但没有改善<64 岁成年人的 QoL。

结论

CV-T-REHAB 改善了心肺适能,达到了与 CV-P-REHAB 相同或更高的水平,并改善了功能能力和 QoL;主要对>65 岁的老年人的 QoL 有效。因此,CV-T-REHAB 可以作为一种替代方案,特别是对于那些难以参加面对面康复计划的人来说。

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